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As a neurosurgeon who focuses mainly on spine surgery, I sometimes use medical devices like pedicle screws and intervertebral cages to treat spinal instability. Watching the Netflix documentary “The Bleeding Edge” made me wonder what the misuse of medical technology means for patients and for doctors.

According to the video’s teaser, “This eye-opening look at the fast-growing medical device industry reveals how the rush to innovate can lead to devastating consequences for patients.” In a nutshell, “The Bleeding Edge” warns of the potential dangers posed by the cozy relationship between industry, doctors, and regulators.

It’s a relationship that’s hard to avoid. If asked, I would struggle to name a spine surgeon who hasn’t been to an industry-sponsored event — I certainly have — or a cardiologist who hasn’t had a drug rep buy lunch for the office at some point in their careers.

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My colleagues and I would like to think we make decisions free of external influence, but we all know that human psychology is complex. Even though we consciously think we’re not being influenced, we can be subconsciously motivated by something as simple as a meal sponsored by a pharmaceutical or device company.

Conflicts of interest aren’t limited to medical devices and drugs. The health insurance industry itself, with its different tiers of reimbursement rates, can generate conflicts by influencing physicians to do more for the patients whose insurance pays more.

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Watching “The Bleeding Edge” made me ask myself: What should we do about surgeons who perform operations that may not be necessary or who use medical devices motivated by inappropriate relationships with their makers? While that may not apply to the physicians in the film — most of whom seemed well-meaning — this practice goes hand in hand with the more unscrupulous tactics of the medical device industry.

Providing patients with better education is part of the solution. Patients who learn more about their conditions or treatments or recoveries, even via Google, are likely to avoid risky procedures and have better outcomes than those who don’t. That said, it is hard for patients or prospective patients to come by data on medical devices and implants, and even harder to interpret them. A surgeon with a very high complication rate, for example, can be either a careless technician or a very good one who treats patients with complex conditions.

Deep down, I believe we need a change of culture to avoid overuse of procedures or misuse of drugs and devices.

Medicine, much like the military and law enforcement, is still a hierarchical field in which many feel intimidated to speak up. While I have not observed what could be characterized as a white wall of silence, I have occasionally been surprised at how the behavior of aggressive proceduralists, who push the bounds of clinical necessity, has been excused. “He’s just old school,” I’ve heard people say, or, “I’m not sure that patient needs surgery, but her surgeon has good hands, so at least there won’t be a complication.”

Like the rest of the world, I watched in horror the trial of Larry Nassar, the team doctor for the USA Gymnastics national team and an osteopathic physician at Michigan State University, who was accused by more than 150 women and girls of sexually abusing them over the past two decades. I couldn’t help but think how many victims would have been spared had one of his medical colleagues acted on their intuition that what was occurring was not only clinically inappropriate but depraved and illegal.

“The Bleeding Edge” sensationalizes individual stories of complications from early-stage medical devices. It obscures the fact that complication rates are still quite low, and that they happen even with properly approved and vetted devices and drugs. But it does show the danger of the cavalier use of investigational medical devices.

Our colleagues mentor us, collaborate with us, teach us, and learn from us. They also need to step in when necessary. Only another orthopedic surgeon would be expected to possess the contextual knowledge to question whether a colleague chose a specific hip implant based on the strength of scientific evidence, or simply because he or she has an inappropriate connection with its maker.

It took cardiologists to blow the whistle on a cardiology group at St. Joseph’s Hospital in Lexington, Ky., which was performing cardiovascular procedures on Medicare patients who didn’t need them.

Better oversight won’t require hospital communities to resemble something out of “The Handmaid’s Tale,” in which people are looking to turn in others to the authorities for minor infractions. Most physicians — most people for that matter — know when something is amiss.

To avoid the kind of dystopia foreshadowed by “The Bleeding Edge,” one in which people can no longer trust their doctors, physicians must act decisively when they identify the rare outlier in their midst. To do anything less would risk our credibility. Worse still, it could risk the lives of the people we took an oath not to harm.

Erich Anderer, M.D., is a neurosurgeon in New York City.

  • Agree with the practice of colleagues of taking kickbacks in the form of foreign trips to attend conferences and family holidays.There need to be a check and balance for this

  • Bravo. I have first hand knowledge of this topic, as a patient (retired RN). This film brings hope to those of us who have been navigating the medical system, post disaster, to get proper care. Mostly, due to a lack of awareness on the part of care providers. This film will impart change minds and attitudes

  • This article should be required reading before viewing the documentary. I fear the public will use the film to condemn or at least disparage and mistrust doctors in general. I can see myself needing to defend the medical profession against wild claims that doctors care only about the money. Having said that I look forward to viewing the film and being aware of the pitfalls of unethical relationships among industry, doctors and regulators. Great article!

    • Dear Mary,
      Like you, I had not viewed the documentary, as I was unaware of it’s existence, even though we view only Netflix, and view online PBS, Masterpiece Mystery, and that’s all for network television for us.

      The documentary is extremely compelling, heartbreaking, and hopefully will be something that has a tremendous impact on everyone who has been victimized by the medical device manufacturers, and the individuals who knowingly seduce the medical professionals, who then perform their respective surgeries on individuals who are totally in need of their own device choices, because they are not informed about the criminal acts of those who lack ethics and integrity; rather the health practitioners who are truly greedy just as much as the manufacturers, their representatives, and anyone else who is complicit with this devastating, disastrous outcome from what needs to be stopped for every single manufacturer, along with the most reprehensible individuals who choose to continue to rob people of their lives, forever.

      This is the most egregious documentary that I have ever viewed, regarding the healthcare profession. The worst thing about this horrific experience is that we are still being treated for one purpose only- money for those whose only motivation is to acquire wealth and power.

      A good friend who was my mentor for several years warned me often, of the following declaration: “remember at all times that your doctor can kill you, and many individuals who enter the medical profession do so for one reason only, to harm, and some to have a license to kill with impunity.” I was warned, and somewhere in my life, I either didn’t want to believe that he was correct, or forgot his warning me about the consequences of the truth that he told me more than once.

      There must be something more that is currently being available for greedy individuals who are collectively responsible for this life altering results of those who are the medical practitioners, about whom my mentor had warned me about so many years ago; he is a psychiatrist who has been well informed first hand witness of his colleagues, who are guilty of their actions against innocent people who go to them for help, and are further harmed beyond description of what words cannot adequately describe the heinous crimes that leave so many lives and the family and friends who have loved ones who have been victimized by their health care practitioners, knowingly who continue to harm their patients for their own fiscal wealth, destroying their patients lives so they are able to have more money than they have ethical characters, and they are truly criminal with their continued practicing their deadly actions because of all things that are evil and are equally subjected to their own hubris, as well.

      Please view this documentary of the heartbreaking experiences that the patients of these ghouls own criminal behavior that leaves their patients and those who are their families and friends in such sadness and despair too.

      It’s long past the time, where anyone who continue to treat their patients with the lifelong consequences of their never again lives of devoid of any quality of life experiences…never again!

  • Dr. Anderer, I appreciate your comments and perspective. I also sincerely appreciate the concern you are expressing for harmed patients. Although I understand your sentiment that more good than harm is done when hips, knees, and other medical devices are implanted, I think some importanat points are being missed: 1. serious adverse events with medical devices are not being reported, counted or trended accurately by the FDA 2. Most are not being reported by surgeons or hospitals 3. Most patients do not report them because they don’t know how or where they can. 4. Worst of all; patients are left in the dark about the known harms.

    The movie exposed how it took one determined woman, the power of the internet, social media, and a former FDA employee who used her computer skills to expose just how bad thise device was. This same thing happened with uterine morcellators. A determined women (& anesthesiologist) who had her cancer upstaged (and eventually died) told her story and then other women came out of the woodwork. That is a huge failure in the safety reporting/tracking system. Since these stories have come out, uterine fibroid surgery standards are being reviewed across the board because we have come to learn that too many women are having surgery (& run the risk of upstaging) before any option is even provided for having their tumors biopsied. We biopsy every other ‘tumor’ to see if it’s cancerous before operatig on it. Why not fibroids? I remember before infections were not counted and reported. Hospital administrators and clinicians lined up in legislative hearings to say ‘We don’t need infection reporting!…infections are just an inevitable outcome and part of the risk of being in the hospital or in the ICU’. Well, we all know now that counting and tracking infections is critical in the work to reduce them. ‘We can’t improve what we don’t measure’ as the saying goes. This movie and harmed patients aren’t attacking clinicians. They are pointing to the medical device industry’s and our federal agency’s failure to put patient safety first. They are not asking for perfection. They are asking that everyone—device manufacturers, the FDA, surgeons, hospitals, administrators—all do their part to ensure that when harm occurs repeatedly, that we have an effective system in place to ensure that it is not dismissed or ignored, but instead accurately reported, tracked, and trended and that patients receive informed consent about the known risks of harm before they sign on the dotted line. Clearly, Essure was a harmful, dangerous device. Billions of dollars in government fines &/or lawsuits at the expense of patient’s lives is not an effective safety system. It took 23 years for the FDA to warn patients about morcellators. Surely, we can do better.

  • This is a lot more like a criminal conspiracy. No Doctor wants to work on anther’s mistake. When my Spine Implant was failing causing excruciating pain, they “lost” my imaging. They are Gas Lighting us, on the numbers, denying that there are any mistakes or less than optimum outcomes. There have been a lot of articles by Spine Surgeons, lately blaming their patients for pain or bad outcomes. It is pretty clear they had to discredit people, and silence or mislead patient groups.

  • Dear Dr. Anderer,
    As a patient who has been harmed by faulty hip implants that were used illegally, I am offended by your comment that the documentary, “The Bleeding Edge sensationalizes individual stories of complications from early-stage medical devices. It obscures the fact that complication rates are still quite low, and that they happen even with properly approved and vetted devices and drugs.” Have you ever considered the possibility that one patient with an adverse event is a representative of thousands of others patients. I know some of these people personally, and will tell you that there is nothing about their stories that has been magnified or sensationalized. This is what life is like for medically harmed patients. To suggest that the numbers are too few to justify concern is extremely dismissive and nothing short of cruel. It is also the response of defensiveness. I understand that when a doctor, a device company rep, an FDA employee, or an industry leader is faced with the harm that is an outcome of their professional judgements and actions, it can be difficult to face the very real possibility that the people, systems, and ideas they have trusted, may in fact be wrong, let alone causing significant physical, emotional, and social damage in people’s lives. It is a human response, but when 37,000 plus women all make the same statements of harm from a device, it is time for a deep look at that defensiveness. Clearly, there is a dissonance between your claim that the harm numbers are low and the representative numbers of people who have spoken up about their experiences with harm.

    Secondly, I believe you have missed the message of the movie. It is not the relationships with device reps in and of themselves which are the problem, it is the trust which providers have in the information which is provided to them by folks who work within a very broken system. We want you to understand that the devices which are coming to you are largely (98%) untested for safety and effectiveness. Practices would change if there was due diligence in seeking out the “studies” which were submitted to the FDA for a measurement of substantial equivalence. Find out about the predicate device upon which a new device’s clearance was granted. If those “studies” or that predicate device do not provide scientifically relevant and statistically sound evidence of safety and effectiveness, raise questions! Change practices based on science or the lack thereof, not on the word of an industry proven to conceal known harm in order to send their device to market.

    You suggest that patients are at fault for the adverse events, and that we need to be better informed and do more research. while patients would do well to be engaged in their own health and care decisions, there are still barriers to safety even for the best educated patient. Dr. Tower’s story is a perfect example. The other most obvious barrier for engaged patients is that we may walk into a consult with a provider, be well informed, and still either not be heard, or be dismissed. Patients are not the problem in this scenario.

    It is past time for doctors to recognize the fact that the system by which devices come to market is broken and dangerous. Stop taking industry at its word and challenge the data. Challenge the means by which the data was obtained. Encourage your professional organizations which are doing research to improve clinical practice guidelines to look across professional journals for information. Groups such as electro-chemical engineers have information related to bio-compatibility that is needed by those who use devices. Search the world’s registries, work to make the adverse event data available through Device Events part of your information system in your hospital or surgical practice group. Last, take responsibility for the dissonance you feel professionally, drop the defensiveness, and insist upon scientific integrity in the data provided to advance the use of medical devices.

    • Ms Radach,

      Thank you for your comments. I’m sorry if you felt that I was minimizing or trivializing the devastation a medical complication can have on a human life – I have seen them, caused them, known people in my family who have suffered from them, and know full well how it can change someone’s life. I was narrowly focusing on the movie’s use of complication stories as a rhetorical device to tell a broader story – whose point neither you nor I have missed. Given the sheer numbers of surgeries performed with medical devices, the complication rates are, in fact, low. That doesn’t make any individual (or group of individuals’) suffering any less unacceptable.

      You and another have mentioned my shifting or deflecting responsibility towards patients. The fact is, I only brought that up to say that properly educated patients will not suffice….the onus falls on us – and only us – as physicians to change culture. Therefore, responsibility lies with me and my colleagues, not you. I’m sorry if that didn’t come across properly. I did not intend this piece to come off as defensive. In fact, I saw it as an exhortation to my colleagues to take responsibility for their actions and, if that isn’t happening, to have another of us step in.

      Surgeons are human beings – we have families, have feelings, make mistakes, sometimes suffer medical complications, and are subject to the same influences and pressures that everyone else is; it’s just that we have an added obligation to ensure that whatever we are doing to help people at their most vulnerable, conforms to the highest possible clinical and ethical standards. Thanks again for your input and I wish you well.

      – Erich A

    • Dr. Anderer,
      Thank you for your reply. These conversations are difficult to have without being in the same room. I respect and appreciate your comments regarding the destruction in patients’ lives because of medical harm from devices. Your stand that physicians must change the culture is also appreciated. However, I still believe that there is a fundamental lack of understanding for how broken the entire system is around the approval/clearance processes of medical devices and the reporting of adverse events. Device harm is not tracked well enough to support the claim that complication rates are actually quite low.
      (I recommend Jeanne Lenzer’s excellent book titled, “The Danger Within Us” to gain a clearer picture of what I am saying.)

      My understanding is that physicians who want to know what the issues are with a device they use, will ask the company rep and maybe look in the registries. This is a woefully inadequate effort! Company reps are paid to sell and get their information from the company. It has been proven in the courts that device companies have a practice of concealing data related to harm. The reps typically do not know, and thus are not able to provide the full picture. This is a very weak link upon which to depend for adverse event data.

      The next resource most commonly used are the registries. This, too, is insufficient. Registry data is limited to what physicians report. The issue here is gross under-reporting of adverse events. To my knowledge, none of my six hip replacements have been reported to any registry. A second issue with registries is that patient reporting is never included. I have already mentioned previously that patient concerns are often dismissed by their doctors who either do not know what types of harm are occuring, or they simply do not believe there is any harm. I have been through this scenario repeated times. Upon one occasion I have handed a surgeon a professional article from an academic journal in a different area of science which was discussing the issues with dissimilar metals being used in hip prostheses. Until that moment, the doctor would quickly dismiss my concerns over the harm this was causing in my body. Overall, harm is not commonly reported and not well understood.

      One would think that the FDA would be a good resource for records of adverse event data, and in truth they possess volumes of data, but trying to find relevant adverse event data within their public presentation is nearly impossible. Although we know that harm is severely under-reported, the FDA still receives almost 70,000 medical device reports every month. It takes two months to two years for those reports to distill into any kind of trending information. This system is grossly insufficient for informing providers of the degree of harm being created by medical devices.

      No matter what the resources are, there is a gap in understanding the harm. This gap is also caused by a lack of application of percentages to population figures. It used to be that the AAOS defined a successful medical device as one which had at least a 10% functioning rate at 10 years. Due to the rate at which devices are altered, that standard is defunct. The other measure used was that a device would not have an early failure rate of higher than 2-5%. Many of the devices have rates that range from 8-15% early failure. By applying those percentages to the 70,000 citizens who receive a medical device implant each year, suddenly the human cost of medical device harm represents a much larger impact than you are suggesting. The cost is not just the numbers of people, but the economic losses due to disability, work force production suffers, families are broken, and the demands on the health care system increase. Does the life of the one harmed patient sitting in your office matter? Of course it does! One life stolen, one life disabled, one life with a broken relationship – one person’s life and health turned upside down times even at the rate of 8% each year and instantly 5,600 individuals have been harmed. If harm is under-reported by even 10%, which would be extremely low, suddenly the volume of harm begins to eclipse the number of implant procedures each year. One cannot simply take the numbers currently available at face value when measuring medical harm. Those numbers are woefully inadequate!

      Providers must stop deflecting the realities of our broken pre-market and post-market system. Fundamentally, there is no such thing as a safe and effective device! Until the medical community understands and acts upon this reality, patients will continue to experience preventable medical harm at unacceptable levels.

      (I recommend Jeanne Lenzer’s excellent book titled, “The Danger Within Us” to gain a clearer picture of what I am saying.)

      I wish you well, and hope that this exchange has brought a new perspective to your understanding and medical practice.

  • Dr. Anderer; With all due respect, when over 400,000 people die every single year from Medical Error and millions are disabled from those errors, the statistics belie your assertion that mistakes and misuses of technology are rare. It is also glaringly clear that Physicians, in general, do not report errors, whether committed by themselves or a colleague. I agree that “culture change” is needed. It is, in fact, required if transparency is ever going to be achieved. And Transparency is critical if death rates from Medical Errors are ever going to be reduced. “Reduced” meaning that the number of Preventable Medical Errors – and they are almost all Preventable – and the resulting deaths are actually known, instead of having to be Estimated.

  • A stirring read. I did see the Dateline story on St.Joseph hospital. A very sad and greedy fact of life. More people have knowledge of this greed than anyone can imagine. I’ve been privy to many of the “office lunches” brought in by drug reps. Another signal: countless brochures in the waiting room. Thank you for bringing this to the forefront in a very thoughtful read.

    • Carol,
      If you have not, be sure to watch the documentary for yourself. Then read the book”The Danger Within Us” by Jeanne Lenzer. That is a thoughtful read!

  • A good example of widespread surgical malpractice / overzealousness that should be reported out is for bone debridement procedures to treat hip pain caused by a putative labral tear in adult athletes. The surgery grinds down the bone in the hip/femur and requires months of PT to regain the ability to walk…

    (1) The diagnostic pathway rests largely on an MRA, which inexplicably shows tears in a large number of asymptomatic individuals. (2) After many years, no surgeon has yet dared do an RCT. (3) Consent for both the MRA and the surgery did not include either of those facts for myself and many others. (4) Both respected othropedic surgeons I consulted in Chicago, one of whom publishes regularly on this procedure, said PT would be a waste of time. Do surgery ASAP. (4) Curiously, PT worked for me. And years later, I’m still pain free. There is now one RCT underway — to evaluate PT. Go figure. I wonder if strict adherence to a PT schedule for months (to regain the ability to walk) has something to do with the procedure’s believed efficacy? We’ll find out…

    This procedure has become a lucrative field that needs some slap downs for overzealousness. (Hopefully someone at STAT gets curious some day.) Remember that your surgeon/physician may have financial incentives for one course of action and consent laws don’t always work in your favor. Ask a non-surgeon specialist for their opinion. Read medical literature helped me make an informed decision. Doing both of these led me to identify logical fallacies behind my recommendation for urgent surgery and two lone dissenting editorials by a orthopedic surgeon and a radiologist (thank you both for speaking out, but neither surgeon thought you had a point).

    • Ryan,
      It sounds like you had expert surgeons, consultation, and effective Physical Therapy. Males with better insurance and connections have better outcomes. Surgeons go into “Sports Medicine” because it selects out lower paying insurance, and women in general. You seem to be implying that the PT was a factor. From my experience PT varies drastically by insurer, practitioner and location. PT was very helpful after one of my surgeries, but it did not relieve the pain. Physical Therapists can be dangerous too, and injuries are not tracked there either.
      I know people were forced to do PT for injures like torn rotator cuffs, who were in so much pain they nearly lost their minds, and all they did was postpone the surgery. There seem to be good outcomes from the people I know that had that surgery. One wasted thousand of dollars on acupuncture and other nonsense. His Physician did not want to waste money and refer him to a surgeon.
      I know older women who have had multiple hip surgeries, failed hip implants that had to be replaced multiple times. I even know one elderly woman who had 2 surgeries as she was dying from Dementia. The Dementia was misdiagnosed for years. She was unable to walk due to her condition. She spent the last year of her life in agony, unable to communicate that she was in pain. The Primary Care Physician did not recognize the Dementia, and the only Neurologist he could refer to had a Brain Tumor. The Neurologist insisted on working in spite of her tumor, and she was not too sharp before the Brain Cancer. The Hospital kept her on because she was profitable, and would misdiagnose post surgical Neurological damage in a way that was good for the hospitals bottom line. A lot of this kind of incompetence is really profitable. This is the level of corruption we are all dealing with, and the reason that The Bleeding Edge is really important.

  • This Surgeon claims that the Bleeding Edge “sensationalizes” these horror stories. He claims that there “complication rates are low.” That is an Alternate Fact. The reason complication rates appear low, is because there are no real reporting requirements. He blames the patents “lack of education” on dangerous or unnecessary procedures. In Fact patients can Google all they want, and all they will find is limited or dangerous information. Try finding any information on any Spine Surgery Center. Even our Federal Agencies, like C.M.S have to work backwards from billing information.
    They are Gas Lighting us all. There is no clear data anywhere. The Industry Insiders made sure that this data could not be collected. Very few Adverse events get reported, the only reporting requirements are up to the Practices or Businesses performing the surgeries. Many of the deaths are attributed elsewhere. Spine Surgery adverse events are attributed to the patient. These adverse events are postponed until after the patient is released. Only cases of death or full body paralysis are even acknowledged. These corrupt Doctors enlisted the help pf Psychologists and marketers, to explain why many of these procedures have less that desirable outcomes. The run the gamut from blaming the patients mindset or the symptoms that had them seek surgery in the first place.
    The so called Opiate Epidemic, and the refusal by the Medical Industry to acknowledge or treat pain, was used to market these Fly by Night Surgical Centers. One had a TV Commercial “Imagine a Life Without Pills” Of course they had no data on outcomes, or types of procedures.
    The powerful Device Industry is another culprit, and combined with overall lack of information everywhere else, the patient would have no ability to evaluate a particular device or procedure. Perhaps after the fact, when the recalls get advertised on TV, they might find out. In many cases there is no pre-surgical information on the devices, for patients. Most of the time they have to trust that the Surgeon, will do the appropriate thing. Often these spine surgeries are only considered out of desperation, after years of pain, misdiagnosis, Physical Therapy, and loss of mobility. Many of these people in desperation sought out useless alternative medicine, ineffective and dangerous pharmaceuticals, steroid shots, though proven to be dangerous, are forced on desperate people with pain. People don’t tend to seek out back surgery except as a last resort, contrary to what these Surgeons and the Industry will tell us.
    The Physicians have been silent, and this article perpetuates the silence, protecting the Industry.
    Physicians are not even aware of the outcomes, and will deny their complicity. They have very powerful Lawyers, Lobbyist and Industry Insiders repeating this jargon, about patient education. They either pretend not to notice there is no factual information for patients, or side with the Industry. They sign Gag Orders, and refuse to even acknowledge mistakes, or less than desirable outcomes. The default position is to delay, deny, postpone and Gas Light patients.
    This is Post Fact America, where patients get blacklisted when they discuss this online. Physicians are just as misled as the general public, or they believe they are helping. Patients who already have these faulty spinal devices, have nowhere to turn. Surgeons won’t even acknowledge the surgery occurred. Hospitals and Surgery Centers have really vicious Lawyers so any patient reporting an adverse outcome will be threatened and their integrity or credibility attacked. When the patients develop lifelong chronic pain, they can attribute that to other factors.
    No one is keeping track. Our government was taken over by industry insiders, something called Regulatory Capture. The Industries that profit here made sure the data can’t be collected. They made the Facts into anecdotes. Another theme in the bleeding edge, is the routine misdiagnosis, postponing and delaying of diagnosis, especially with women. This bias is well documented with Scientific research.
    Remember that the surgeon who responded here is a marketer, repeating talking points he heard repeated at Industry sponsored “Medical Conferences.” They rewrote the narrative to blame patients for their lack of “education.”
    This kind of tactical misinformation should be criminal, but our government failed to protect us from this sort of weaponized health care marketing. That might be why the US has the worst outcomes of any developed nation.

    • Very well stated indeed. The patient blaming in this article came through loud and clear despite the author’s attempt to mask it by admitting that “occasionally” doctors perform unnecessary surgeries, are influenced by relationships with pharma and device manufacturers, etc. All freestanding spinal surgery centers should be closed immediately. Those places are an abomination and responsible for deaths, immense suffering and wasting millions of dollars in health care resources.

    • Thanks B. Delany!

      Dr Anderer even linked to an article on the “White Wall of Silence.” He claims that the patients experiencing adverse events are “rare outliers.” Of course there is no one reporting advents, or counting these so called outliers. I seem to meet a lot of these Outliers, people with rods in their spines, and other survivors. Those surgical implant rods are no longer recommended, and they are encouraging removal. That is only one example. He did not mention how many of these implants that were recommended and installed by Surgeons like himself, now have to be removed. A lot of of the people who were subject to this “Market Based Surgery” are either already dead, or are drinking and drugging themselves to death. None of them have been counted. The failure rate of these surgical implants is effectively censored. Since they did a lot of these surgeries on the Elderly, because Medicare paid for it, they are already dead, or dying so those “adverse events” won;t be counted either.
      This is Orwellian. We can see how the Industry attacks and undermines any attempt to throw light on any of it. Reporting is up to the same people profiting. Those “Community Health Advocates” are all funded by the industry. They never report anything that might inconvenience the interests financing them. We all know what happens to Whistle blowers, which us why there have not been any. Physician have been silent, except to push the industry agenda, like this one. He has no doubt seen patients who already had surgery by another surgeon. He must believe they are outliers too. He was certainly not curios enough to count them. He does not know that no one else is counting them either. The Industry tells Physicians that noticing adverse events, botched surgeries, or even dangerous pharmaceuticals could lead to liability.
      This is the same phenomenon we saw at the Border, when the administration took children away from their parents. The same thing that allowed the Germans to ignore the Nazi Genocide. They were just doing their job, or they did not know.

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